A Conversation About Bariatric Surgery, Medication, and Patient Outcomes

In this episode of MD Newsline, Dr. Jamie Almandoz, Associate Professor at UT Southwestern Medical Center and Medical Director of the Weight Wellness and Obesity Medicine Program, discusses the evolving science of post-bariatric weight management, the rising use of GLP-1 medications, and the role of multidisciplinary care in treating obesity as a chronic illness. He shares practical insights into weight regain after bariatric surgery, how medications can support long-term outcomes, and the importance of nutrition, mental health, and individualized care. Episode Highlights: Understanding Post-Bariatric Weight Regain Dr. Almandoz explains why obesity is not cured by surgery and how weight regain—up to 40% on average—is common due to metabolic adaptation, hormonal shifts, and anatomical changes. He emphasizes the need to redefine success by health improvement, not just weight loss. The Role of GLP-1 and Incretin Therapies GLP-1 receptor agonists and other medications have become powerful tools in obesity management. Dr. Almandoz discusses their potential to support both pre- and post-surgical patients, how they affect hunger and calorie intake, and their limitations, including malnutrition risks and bone density concerns. Nutrition and Long-Term Risks Dr. Almandoz warns of malnutrition and lean mass loss among patients using potent weight-loss medications, especially when combined with low-quality diets. He highlights the need for dietary counseling, micronutrient screening, and follow-up—particularly for postmenopausal women and those with chronic illness. Multidisciplinary Care and Mental Health From registered dietitians to primary care providers, a coordinated care team is key. Dr. Almandoz advocates for mental health screening, SMART goal-setting, and destigmatized obesity treatment, recognizing that each patient's health goals and progress vary. Personalized and Precision Medicine in Obesity As newer medications target different biological pathways, Dr. Almandoz calls for a precision approach to obesity care—matching treatment combinations to the individual's physiology, comorbidities, and life context, rather than applying a one-size-fits-all model. Key Takeaway: Obesity is a chronic disease requiring lifelong care. Neither surgery nor medication alone is curative—personalized, multidisciplinary strategies that address nutrition, mental health, and physical health are essential to improving outcomes and quality of life. Resources & Links: Website: MD Newsline Newsletter: Subscribe Here Connect with Dr. Jamie Almandoz: LinkedIn